Anti-lymphocyte globulin

Anti-lymphocyte globulin (ALG) is an infusion of animal- antibodies against human T cells which is used in the treatment of acute rejection in organ transplantation. Its use was first reported by Thomas Starzl in 1966.[1] Its use in transplant was supplanted by thymoglobulin between 1984 and 1999.[2]

It has also been used in the treatment of aplastic anemia.[3][4][5]

It is less commonly used than the similar anti-thymocyte globulin (ATG), and like ATG it is associated with cytokine release syndrome in the short term and an increased risk of post-transplant lymphoproliferative disorder in the long term. ALG is more likely to cause side effects than ATG, but is safer than OKT3.

The product was manufactured by Upjohn and Merieux, as well as the Schweizerisches Serum- und Impfinstitut in Bern, the latter of which was made by injecting horses with human thoracic duct lymphocytes and was called "Lymphoser Berna".[3][6]

References
  1. Hakim, Nadey; Danovitch, Gabriel (2013). Transplantation Surgery. Springer Science & Business Media. p. 11. ISBN 9781447136897.
  2. Verghese, PS; Dunn, TB; Chinnakotla, S; Gillingham, KJ; Matas, AJ; Mauer, MS (January 2014). "Calcineurin inhibitors in HLA-identical living related donor kidney transplantation". Nephrology, Dialysis, Transplantation. 29 (1): 209–18. doi:10.1093/ndt/gft447. PMC 3888312. PMID 24414376.
  3. Frickhofen, N; Kaltwasser, JP; Schrezenmeier, H; Raghavachar, A; Vogt, HG; Herrmann, F; Freund, M; Meusers, P; Salama, A; Heimpel, H (9 May 1991). "Treatment of aplastic anemia with antilymphocyte globulin and methylprednisolone with or without cyclosporine. The German Aplastic Anemia Study Group". The New England Journal of Medicine. 324 (19): 1297–304. doi:10.1056/NEJM199105093241901. PMID 2017225.
  4. Kaya B, Davies CE, Oakervee HE, Silver NC, Gawler J, Cavenagh JD (September 2005). "Guillain Barré syndrome precipitated by the use of antilymphocyte globulin in the treatment of severe aplastic anaemia". J. Clin. Pathol. 58 (9): 994–5. doi:10.1136/jcp.2004.020354. PMC 1770826. PMID 16126887.
  5. Lichtman, Marshall A.; Spivak, Jerry L.; Boxer, Laurence A.; Shattil, Sanford J.; Henderson, Edward S., eds. (2000). "Commentary on and reprint of Speck B, Gluckman E, Haak HL, van Rood JJ, Treatment of aplastic anaemia by antilymphocyte glubulin with and without allogeneic bone marrow infusions, in Lancet (1977) 2:1145–1148". Hematology landmark papers of the twentieth century. San Diego: Academic Press. pp. 709–714. doi:10.1016/B978-012448510-5.50159-X. ISBN 978-0-12-448510-5.
  6. Speck, B; Gratwohl, A; Nissen, C; Osterwalder, B; Würsch, A; Tichelli, A; Lori, A; Reusser, P; Jeannet, M; Signer, E (1987). "A comparison between ALG and bone marrow transplantation in treatment of severe aplastic anemia". Thymus. 10 (1–2): 147–58. PMID 3324403.
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